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CPT code 28111: Metatarsal excision, first metatarsal head2026 Medicare rate & RVUs in Washington, DC area

Reports surgical removal of a limited portion of the first metatarsal head, such as a painful bony prominence, without removing the entire bone.

CMS RVU26DEffective Oct 1, 2026One payment locality698 Medicare services in 2024

In Washington, DC area, Medicare pays $535.16 for 28111 in the office and $334.10 when it’s performed in a hospital or facility.

$535.16Office (non-facility)
$334.10Hospital or facility
+13.2%vs the national office rate ($472.96)

Check a contract rate as a % of Medicare · 28111 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28111 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28111 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 28111 covers

The surgeon removes a limited portion of the head of the first metatarsal, the long bone behind the great toe. This may address a painful prominence or localized bone problem. The procedure is performed by a foot and ankle surgeon or other qualified surgeon, commonly in an operating room or ambulatory surgery center. The operative report should identify the first metatarsal and describe the portion removed and the reason for excision.

Select this code when the work is a partial resection of the first metatarsal head, rather than a resection of another metatarsal or removal of the whole bone. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and the others are subject to the standard multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 28111

Across 109 of 109 payment localities, the office rate for 28111 runs from $423.59 in Arkansas to $609.69 in San Benito County, CA. Washington, DC area pays $535.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

28111 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$535.16
  2. Los Angeles, CA · California$526.16−$9.00
  3. Miami, FL · Florida$512.81−$22.35
  4. Chicago, IL · Illinois$499.35−$35.81
  5. Manhattan, NY · New York$540.93+$5.77
  6. Alaska · Alaska$567.19+$32.03
  7. Alabama · Alabama$429.12−$106.04

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

28111 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$423.59$276.98
ArizonaArizona$461.42$296.03
Bakersfield, CACalifornia$496.50$309.44
Chico, CACalifornia$494.83$307.76
El Centro, CACalifornia$494.92$307.86
Fresno, CACalifornia$494.83$307.76
Hanford, CACalifornia$494.83$307.76
Madera, CACalifornia$494.83$307.76

28111 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$423.59

$567.19

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28111 office rate range by state
State / territoryOffice rate rangeLocalities
AK$567.191
AL$429.121
AR$423.591
AZ$461.421
CA$494.83–$609.6929
CO$489.311
CT$502.261
DC$535.161
DE$468.501
FL$469.57–$512.813
GA$445.50–$481.742
GU$504.531
HI$504.531
IA$437.491
ID$440.321
IL$458.34–$499.354
IN$442.571
KS$436.301
KY$439.551
LA$439.19–$458.532
MA$487.12–$533.472
MD$476.57–$535.163
ME$443.06–$463.602
MI$450.37–$475.522
MN$468.341
MO$432.89–$459.223
MS$428.281
MT$472.921
NC$447.101
ND$462.041
NE$439.441
NH$482.421
NJ$507.84–$530.682
NM$452.841
NV$470.181
NY$453.16–$553.665
OH$448.141
OK$438.161
OR$466.35–$502.782
PA$448.42–$491.282
PR$475.841
RI$483.631
SC$448.401
SD$460.761
TN$438.341
TX$445.83–$487.848
UT$453.871
VA$462.68–$535.162
VI$475.841
VT$461.011
WA$485.95–$543.112
WI$448.191
WV$443.291
WY$468.181

See 28111 in every payment locality

How the 28111 rate is calculated

Each of 28111’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 28111

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.02

5.02 RVUs× 1.000 GPCI

Practice expense8.59

8.59 RVUs× 1.000 GPCI

Malpractice0.55

0.55 RVUs× 1.000 GPCI

Adjusted RVUs

14.1600

Conversion factor

$33.4009

Medicare rate

$472.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,125

Code
28111
Physician work
5.02
Practice expense
8.59
Malpractice
0.55

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28111 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work5.02× 1.0545.2911
Practice expense8.59× 1.17810.1190
Malpractice0.55× 1.1130.6122
Total RVUs16.0222
Conversion factor× 33.4009

Office rate, Washington, DC area$535.16

Office: (5.02 × 1.054 + 8.59 × 1.178 + 0.55 × 1.113) × $33.4009 = $535.16

Facility: (5.02 × 1.054 + 3.48 × 1.178 + 0.55 × 1.113) × $33.4009 = $334.10

Open 28111 in the RVU calculator

Payment rules and modifiers for 28111

28111 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28111

Metatarsal excision, first metatarsal head

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28111

Metatarsal excision, first metatarsal head

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28111 without 50 · national office

$472.96

Metatarsal excision, first metatarsal head

28111-50 · Bilateral: 150%

$709.44

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 28111

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28111
CodeHow it relatesOffice range, Washington, DC area
Same family
28110Metatarsal resection, partial fifth-head excisionPartial resection of the fifth metatarsal head rather than the first.$532.43
28112Metatarsal head resection, second metatarsal headPartial resection of the second metatarsal head.$548.02
28113Metatarsal excision, third, fourth, or fifth metatarsalPartial resection of the third metatarsal head.$662.57
Used instead
28114Metatarsal head excision, second through fourth metatarsalRemoval of metatarsal heads rather than a limited resection of the first head.$1,259.28
28140Metatarsal excision, complete bone removalRemoval of a metatarsal, rather than partial resection of its head.$631.05
28296Bunion correction, distal first metatarsal osteotomyHallux valgus correction using a distal metatarsal osteotomy rather than isolated head excision.$1,005.63

How 28111 has changed in Washington, DC area

28111 · Office / nonfacility

$535.16

Effective 2026-10-01

The base rate is $12.09 higher than on 2025-10-01, moving from $523.07 to $535.16 (2.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $523.07changed to$535.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.15 changed to 5.02
    • Practice expense RVU 8.49 changed to 8.59
    • Malpractice RVU 0.52 changed to 0.55
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $541.86changed to$523.07

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.58 changed to 8.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $533.02changed to$541.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $556.49changed to$533.02

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.51 changed to 8.58
    • Malpractice RVU 0.53 changed to 0.52
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $577.35changed to$556.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.52 changed to 8.51
    • Malpractice RVU 0.56 changed to 0.53
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $590.33changed to$577.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.71 changed to 8.52

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $590.05changed to$590.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.38 changed to 8.71
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $585.43changed to$590.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.46 changed to 8.38
    • Malpractice RVU 0.53 changed to 0.56
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $587.85changed to$585.43

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.52 changed to 8.46
    • Malpractice RVU 0.54 changed to 0.53

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $588.13changed to$587.85

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.53 changed to 8.52
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $587.48changed to$588.13

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $593.15changed to$587.48

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.58 changed to 8.53
    • Malpractice RVU 0.59 changed to 0.56

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $590.19changed to$593.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $585.18changed to$590.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.52 changed to 8.58
    • Malpractice RVU 0.57 changed to 0.59
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $599.39changed to$585.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.63 changed to 8.52
    • Malpractice RVU 0.60 changed to 0.57
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $599.39

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$535.16$334.10RVU26D
2026-07-01$535.16$334.10RVU26C
2026-04-01$535.16$334.10RVU26B
2026-01-01$535.16$334.10RVU26A
2025-10-01$523.07$351.50RVU25D
2025-07-01$523.07$351.50RVU25C
2025-04-01$523.07$351.50RVU25B
2025-01-01$523.07$351.50RVU25A
2024-10-01$541.86$358.94RVU24D
2024-07-01$541.86$358.94RVU24C
2024-04-01$541.86$358.94RVU24B
2024-03-09$541.86$358.94RVU24AR
2024-01-01$533.02$353.09RVU24A
2023-10-01$556.49$364.79RVU23D
2023-07-01$556.49$364.79RVU23C
2023-04-01$556.49$364.79RVU23B
2023-01-01$556.49$364.79RVU23A
2022-10-01$577.35$373.32RVU22D
2022-07-01$577.35$373.32RVU22C
2022-04-01$577.35$373.32RVU22B
2022-01-01$577.35$373.32RVU22A
2021-10-01$590.33$374.69RVU21D
2021-07-01$590.33$374.69RVU21C
2021-04-01$590.33$374.69RVU21B
2021-01-01$590.33$374.69RVU21A
2020-10-01$590.05$380.29RVU20D
2020-07-01$590.05$380.29RVU20C
2020-04-01$590.05$380.29RVU20B
2020-01-01$590.05$380.29RVU20A
2019-10-01$585.43$376.11RVU19D
2019-07-01$585.43$376.11RVU19C
2019-04-01$585.43$376.11RVU19B
2019-01-01$585.43$376.11RVU19A
2018-10-01$587.85$377.02RVU18D
2018-07-01$587.85$377.02RVU18C
2018-04-01$587.85$377.02RVU18B
2018-01-01$587.85$377.02RVU18AR1
2017-10-01$588.13$378.39RVU17D
2017-07-01$588.13$378.39RVU17C
2017-04-01$588.13$378.39RVU17B
2017-01-01$588.13$378.39RVU17A
2016-10-01$587.48$378.66RVU16D
2016-07-01$587.48$378.66RVU16C
2016-04-01$587.48$378.66RVU16B
2016-01-01$587.48$378.66RVU16A
2015-10-01$593.15$380.98RVU15D
2015-07-01$593.15$380.98RVU15C
2015-04-01$590.19$379.08RVU15B
2015-01-01$590.19$379.08RVU15A
2014-10-01$585.18$377.64RVU14D
2014-07-01$585.18$377.64RVU14C
2014-04-01$585.18$377.64RVU14B
2014-01-01$585.18$377.64RVU14A
2013-10-01$599.39$376.02RVU13D
2013-07-01$599.39$376.02RVU13C
2013-04-01$599.39$376.02RVU13B
2013-01-01$599.39$376.02RVU13AR

Price 28111 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

28111 billing questions

How is this code distinguished from 28110?

This code is for partial resection of the first metatarsal head. Code 28110 applies to the fifth metatarsal head.

When is 28112 more appropriate?

Use 28112 when the partial resection involves the second metatarsal head, rather than the first.

Does the global period include routine postoperative care?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.

What documentation supports reporting this code?

The operative report should establish that the surgeon removed part of the first metatarsal head and document the indication and extent of the resection.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment is restricted for this code. Co-surgeons are paid only when supporting documentation is provided.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 28111PPRRVU2026_Oct_nonQPP.csv, line 3,125 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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